(Not printed at Government expense)

 

United States
of America

ongressional Record

PROCEEDINGS AND DEBATES OF THE 824 concress, SECOND SESSION

 

 

Medical Research: A National Bulwark

ADDRESS

OF

HON. JOHN E. FOGARTY

OF RHODE ISLAND

(Psinted in the ConcresstonaL Rzcorp of
May 23, 1952)

Mr. McCORMACK. Mr. Speaker, un-
der leave granted to extend my remarks
in the Recor», I include the following ad-
dress by the Honorable Joun E. Fogarty,
of Rhode Island, before the medical con-
ference of the Muscular Dystrophy Asso-
ciations of America, Inc., at Park-Shera-
ton Hotel, New York City, May 17,1952:

MEDICAL RESEARCH: A NATIONAL BULWARK
(Address by Hon. JoHN E. Fogarty, of Rhode
Island)

I would like to tell you, this morning,
something about the way in which one Con-
gressman views the health of the American
people and how you as members of the Mus-
cular Dystrophy Association can help the
Congress as a whole to marshal an effective
attack on diseases which cause so much un-
necessary suffering and disability.

I have been a Member of the House of
Representatives for the past 12 years. For
the last 6 of these years I have served on the
Appropriations Subcommittee which has held
hearings each year on the requests for funds
for research and other programs of the Pub-
lic Health Service of the United States.

I am now chairman of that subcommittee
and in this position it has been my privilege
and cbligation to study and try to under-
stand our health problems. It has been par-
ticularly important to analyze the relation-
ship betwen medical research and the health
of the Nation if I was to be able to render
a scund legislative judgment on the state-
ment of needs expressed to the committee
by the Office of the Sugeon General.

At the present time, about $180,000,000 are
spent annually on medical research. Since
the war there has also been substantial
growth in medical institutions and programs.
Agencies such as yours have been set up as
an expression of the public desire to contrib-

213332—43647

ute to the campaigns against specific dis-
eases. Research, and training in research
work, in the Nation’s medical schools and
universities have increased. More facilities
for medical care and rehabilitation have been
built; private foundations and industry
have continued to make important con-
tributions; States and municipalities have
shown an increasing ability to meet their
own health needs; and, through Congress,
the people have placed upon the Federal
Government the responsibility for supple~
menting and insuring the continuity of ex-
pansion in medical research.

These advances, significant though they
are, cannot be viewed with complacency.
They are an indication of the kind of prog-
ress that can be expected if we plan and act
with wisdom and foresight, but we have a
long way to go before we can claim victory.

For humanitarian reasons, we should bend
our efforts toward the control or eradication
of diseases which will eventually yield to
scientific and public health attack. But,
beyond that, we should be concerned with
the health of our people from the point of
view of our national economy. The Federal
Government is giving some kind of direct
medical care to more than one-sixth of the
Nation—that is, about 24,000,000 people,
most of them veterans. Our Federal medi-
cal services cost us nearly $2,000,000,000 a
year. More than 85 percent of the total
Federal medical expenditures is for direct
medical care. It has been estimated by the
American Medical Association that the total
cost of illness in this country-—and here we
are talking about all costs, including loss of
wages and loss of production—is nearly $27,-
C00,C00,000 a year. These are losses which
we cannot afford and have no right to tol-
erate.

I am convinced that the basic answer to
these staggering expenditures is more medi-
cal research—research which will have to be
supported by both private groups and the
Federal Government. As you know, the
arm of our Government which is responsible
for medical research is the Public Health
Service, and more specifically, its component
body, the Institutes of Health at Bethesda,
Md. Soon after the war, this research center

began to assume an organizational pattern
calling for separate institutes dealing with
the chronic diseases. So—by the time I had
become chairman of the subcommittee in
1949—there was a National Cancer Insti-
tute, a National Heart Institute, a National
Instiute of Dental Research, and a National
Institute of Mental Health, as well as two
institutes concerned with the communi-
cable diseases and nutritional research.

During these years, we in Congress became
increasingly aware of public support favoring
the establishment of additional research in-
stitutes to deal with specifc disease entities
such as multiple sclerosis, cerebral palsy,
polio, and so on. There have been several
bills before Congress calling for the establish-
ment of perhaps 10 such institutes.

You can see the fundamental issues with
which we were confronted. It was apparent
that the American people wanted Govern-
ment support for research programs dealing
with several of the chronic and crippling
diseases. Yet, could effective research really
be so divided? Could so many institutes be
established as a matter of organization and
administration? What were the values to
be derived from identifying each research
program with a specific disease?

These bills and many other considerations
led to what is known as Public Law 692.
Under one of the provisions of this law,
passed in 1950, two new Public Health re-
search institutes were created—the National
Institute of Neurological Diseases and Blind-
ness, and the National Institute of Arthritis
and Metabolic Diseases. These two insti-
tutes are responsible for investigations into
such closely related neurological problems
as cerebral palsy, epilepsy, and multiple
sclerosis, and into such metabolic disorders
as arthritis, rheumatism, and diabetes. Al-
though muscular dystrophy is generally rec-
ognized as neurological in origin, the Ar-
thritis Institute is conducting and support-
ing research on the metabolism and physi-
ology of the muscle, which I understand is
relevant to the problem.

The companion interest of the two new in-
stitutes on different aspects of the same dis-
ease is, I think, proof of the need for flexi-
bility in a research program. For that rea-
2

son, Public Law 692 gave to the Surgeon
General of the United States the authority
to create new institutes if circumstances re-
quire them. It recognized, in other words,
that we cannot always set up neat little
boxes for research into specific diseases. In
part, this integration is evident in the plan
of the new Clinical Center, which is now
being built at Bethesda, and which is de-
signed to provide opportunities for a uni-
fled approach to clinical and basic research.

During the past 3 or 4 years, our committee
has spent long hours discussing the plans for
this center and how it could best serve our
people. It was decided that all seven of the
research institutes should have portions of
their programs, including research patients,
in the Clinical Center. Consequently, there
will be a close-working relationship among
the many compiex disciplines which make up
medical research today.

There are several other provisions of Pub-
llc Law 692. I will take time to describe only
one more,

Each major Public Health Service research
program is guided by a National Advisory

‘Council which reviews all programs and
makes recommendations to the Su geon
General. Each Council is composed of 12
non-Federal scientists and laymen. The key
words here are, I think, “non-Federal scien-
tists and. Iaymen.” They illustrate that
these scientific programs are nonpartisan
and that the layman not only has a stake
in them, but also has much to contribute.

In telling you something of what it means
to be a Congressman interested in public
health, I want to point out that sometimes
he must struggle with his conscience to re-
concile the demands of his constituents with
what he honestly believes is best for every-
one. The difficult question is: What is the
relative importance of long-range problems
such as medical research, as compared with
immediate issues? Can we recommend to
the Congress that medical research is more
important to the Nation than funds for de-
fense? To get the answer one has to do
some fairly elementary arithmetic—almost
like a household budget:

The total Federal income is around $71,-
000,000,000. Of that, about fifty-one bil-
lion is earmarked for the military and for
foreign aid. That leaves roughly twenty bil-
lion to use for nonmilitary spending. But
the total budget for nonmilitary Federal ac-
tivities comes to thirty-four billion two hun-
dred million. That means a $14,400,000,0c0
deficit. Dare we cut back on defense spend-
ing, or do we, instead, cut civilian pro-
grams?

I will tell you how I stand on this issue.
I agree 100 percent with that section of the

213332—43647

CONGRESSIONAL RECORD

Hoover Committee Report which said: “The
Government can protect its financial posi-
tion best by using every means to prevent
disease rather than to treat it by unlimited
hospitalization. This will also promote the
national welfare in peace and a stronger
manpower to preserve our security in war.
The highest priority in Federal medical ex-
penditures should, therefore, go to the re~
search and public-health fields. We must,
and to a large degree we can, if we will, con-
trol disease.”

Fortunately, we have been able with a
clear conscience to sustain budgets for the
most important Federal health activities. It
is a matter of pride to me, personally, that,
since the war my subcommittee has not in
any year reduced the executive budget for
medical research, and the Congress itself
has invariably followed its recommendations.
Indeed, the committee and the Congress have
often allocated more funds for basic research
programs than the executive budget asked
for. But even these gains have not been
enough.

All of you realize, I am sure, that the de-
cisions of Congress are prompted by what it
knows the people want. In the matter of
health needs, the public must make its wants
known to the Congress. These wants can and
should be forcefully presented through the
joint efforts of both public and private
groups. The cooperative programs of the
National Heart Institute with the American
Heart Association, of the National Cancer In-
stitute with the American Cancer Society,
and of the National Institute of Mental
Health with the National Association for
Mental Health are excellent examples of how
different groups can effectively work to-
gether.

If all those interested in the neurological
and muscular disorders could achieve unity
in purpose and approach, their combined
strength would go a long way toward realiz-
ing an effective program. Separately, their
problems may seem dwarfed by the other
diseases—heart disease with between 9,000,-
000 and 10,000,000 sufferers, cancer with
700,000, and nearly 500,000 mentally. ill.
contrast with these, muscular dystrophy’s
100,000 may seem very small. But muscular
dystrophy, cerebral palsy, epilepsy, and mul-
tiple sclerosis—to name only four related dis-
eases—together claim more than a million
victims today. This is a figure to be reck-
oned with.

All of us here know that medical science
has virtually no specific knowledge about
muscular dystrophy and related diseases.
But we know, too, that fundamental research

In

cuts across all disease lines, so that a re-
search project from another institute may
yield the clue to the cause of muscular
dystrophy. The all-important thing today is
to get sound research done by competent re-
searchers, History has proved that it pays
off.

When I spoke of 100,000 cases of musular
dystrophy as a relatively lesser problem, it
was only on the basis of numerical compari-
s0n with heart disease and cancer. In our
country it is the individual who counts.
Resources are mobilized as quickly to save
1 person as 100. A recent example of that
is the story of the airmen in Korea who
jeopardized their own lives to permit a heli-
copter to land and pick up a fellow airman
from the enemy’s back yard. To us, the
individual is important and that is why the
programs of voluntary agencies such as this
are significant. The victims of muscular
dystrophy need our help now, not 10 years
from now. At the same time, however, we
must strengthen the Nation’s research work
on neurological diseases. There is evidence
that fine progress is being made at the Na-
tional Institute of Neurological Diseases and
Blindness. Dr. Pearce Bailey, director of
that program, will tell us about its activi-
ties in a few minutes. My hope is that all
of you here today will not think of this
Federal research program as something re-
mote and abstract. Think of it rather as a
unit of Government with which you will
want to establish the close personal and
organizational relationships which have
been so successful in other fields.

For my part, I want every person suffering
from muscular dystrophy to know that I, as
a Member of Congress and as a fellow citi-
zen, will do my utmost to further research
which will cure them of this dread disease.

There must be an answer to the enigma
of muscular dystrophy, and we must find it.
Our scientists believe that, given the funds,
the manpower, and the falities, they will
in time find the answer. It is the job of
the public to impress the Congress to pro-
vide the means needed if these men are to
find the solution they seek.

Earlier I said that many decisions in Con-
gress were the result of the desires of the
people. I want to stress the need for even
more public support for issues relating to the
Nation’s health. Members of Congress have
to be convinced that funds for medical re-
search are really needed. The convincing
can only be done by groups such as yours
and by the general public. I sincerely hope
that all of you will use every means in your
power to see that our research work is pur-
sued until victory against disease has been
achieved,

U.S. GOVERNMENT PRINTING OFFICE; 1952